McClelland Lisha, Carr Esmond, Kamani Tawakir, Cade Jennifer, Young Kate, Mortimore Sean
Royal Derby Hospital, Uttoxeter Road, Derby DE22 3NE, UK.
ISRN Otolaryngol. 2011 Nov 23;2011:750676. doi: 10.5402/2011/750676. Print 2011.
Objectives. To assess the outcome of transoral laser-assisted microsurgery (TLM) with regards to local and distant tumour control, quality of voice and swallowing. Design. Retrospective review of patients with five-year follow-up period. Setting. Royal Derby Hospital Head and Neck Department. Participants. All patients undergoing TLM with a diagnosis of Tis, T1, or T2 glottic tumour following endoscopic biopsy. Main Outcome Measures. Speech, swallowing, cancer-free survival, laryngectomy-free survival, and mortality rate. Results. 22 patients were treated for early glottic carcinoma with TLM. The 5-year local control rate for T1 tumours is 89% and 56% for T2 tumours. The laryngectomy rate was 4.5%. The mortality rate from local and distant disease was 4.5% with an overall mortality rate of 22% from all causes. 40% of patients had normal voices and a further 45% had only mild or moderate voice change. At their last followup, no patients assessed had any difficulty swallowing relating to their treatment for glottic cancer. Conclusion. Transoral Endoscopic CO2 laser microsurgery is a valid technique for treating early glottic tumours.
目的。评估经口激光辅助显微手术（TLM）在局部和远处肿瘤控制、嗓音质量及吞咽功能方面的治疗效果。设计。对患者进行为期五年的回顾性随访研究。地点。皇家德比医院头颈科。研究对象。所有经内镜活检确诊为Tis、T1或T2期声门型肿瘤并接受TLM治疗的患者。主要观察指标。言语功能、吞咽功能、无癌生存率、无喉切除术生存率及死亡率。结果。22例早期声门型癌患者接受了TLM治疗。T1期肿瘤的5年局部控制率为89%，T2期肿瘤为56%。喉切除术率为4.5%。局部和远处疾病导致的死亡率为4.5%，所有原因导致的总死亡率为22%。40%的患者嗓音正常，另有45%的患者仅有轻度或中度嗓音改变。在最后一次随访时，所有接受评估的患者均未出现与声门型癌治疗相关的吞咽困难。结论。经口内镜二氧化碳激光显微手术是治疗早期声门型肿瘤的有效技术。
